Leong Sze Hian/
3 Key Areas
With reference to the three key health areas of infrastructure, cost and ageing policies cited by the new Health Minister, I would like to make the following remarks: -
"On the first issue, the Health Minister (Gan Kim Yong) said it was necessary to take stock of demographic trends adding "we will need to plan ahead not only in terms of physical capacity but also in terms of human resource development, to ensure sufficient supply of healthcare professionals and workers".
Is the new Minister saying that his predecessor did not plan at all, since the increase in the total number of hospital beds was zero over the last 10 years or so, and that this is vis-à-vis a one million increase in the population and also promoting the increase in medical tourists to 850,000?
As to "human resource development", when I went to a polyclinic and hospital recently, the receptionist, nurse, X-ray technician and doctor, were all foreigners, and I had some difficulty understanding their accent. I have heard that some non- English speaking Singaporeans have had some difficulty communicating with foreign healthcare professionals.
Since the former Health Minister did not tell us, can the new Minister tell us the proportion and breakdown of healthcare professionals like doctors, nurses, etc., who are non-Singaporeans?
I understand that the national Medical School is acutely short of funding because of insufficient financial support from the Government.
Would the Minister like to comment on this?
Depleted Medisave Accounts
"The problem is especially real for retirees with limited cash savings and middle- income families with elderly parents and sick children to look after".
Can the Minister tell us how many Singaporeans age 60 and above, have nothing or less than $1,000 in their Medisave Account?
How many do not have any form of medical insurance?
How many children who are sick or without an adverse health history, are not covered by any medical insurance, like Medishield?
In this regard, I understand that Singapore is probably the only country in the world that excludes children's congenital conditions from the national health insurance scheme (Medishield in the case of Singapore).
Passing the Baton
Mr. Khaw wrote about "unfinished business" in his last blog entry as Health Minister and paying tribute to Mr. Khaw, Mr Gan said: "My first impression is that Minister Khaw has done a great job to improve the health-care framework ... The quality of healthcare in Singapore is something we can all be proud of".
This in my view, may go down in the annals of healthcare history as perhaps the greatest understatement by a Minister when we look back in the future on the so called "transformation" in our history - something which we may really be very proud of if and when the Health Minister fixes all the problems that he has inherited.
The former Health Minister's consistent rhetoric has been that our 3Ms (Medisave, Medishield, Medifund) system is affordable, efficient and admired by other countries. What has this left us with, in terms of outcomes for healthcare?
• About 21 per cent of Singaporeans who sought financial counselling from Credit Counselling Singapore had to do so due to medical costs;
• The zero increase in total hospital beds over the last decade in relation to the surge in population;
• A 99 per cent unsuccessful rate (or 1% success rate) for patients’ applications to downgrade to lower classes of hospital rooms;
• The last available disclosed statistic from the Chairperson of the Government Parliamentary Committee (GPC) on Health was that 750,000 people had no form of medical insurance;
• Public healthcare spending is only about two per cent of GDP, which is one of the lowest, if not the lowest in the world;
• Public hospitals' average hospitalisation bills have increased by as much as double over the last four years;
• $86 million of Medifund surpluses were transferred to the protected reserves, instead of allowing Medifund usage for the needy at Polyclinic out-patient treatment;
• More and more non-subsidised drugs and treatments and a refusal to disclose standardised drugs list like most countries do;
• A refusal to disclose Medifund applications success rates on a patients' rejected basis, instead of total applications basis;
• A refusal to make public the criteria for approving Medifund applications;
• Longer and longer waiting times for practically all types of subsidised medical treatment - up to years for dental;
• Continuing to shift the burden of healthcare financing ratio of public/private spending from 75:25 to about 50:50 now;
• About half of Medisave account holders' Medisave being consumed for other family members - thus creating the likely future problem of insufficient funding for account holders as they grow older; and
• No transparency in the funding to public hospitals vis-à-vis the subsidies shown in patients ' hospital bills.